Health Freedom Watch
Medical Laboratories Could Be Compelled
to Report Citizens' Blood-Sugar-Test Results to Local Governments
first time in our nation's history, a local health department
has proposed compelling medical laboratories to report blood-sugar-test
results. The New York City Department of Health and Mental Hygiene
floated the proposal in early July. The New
York Times says that although medical laboratories have
been mandated to report information about infectious diseases
(such as hepatitis), they have never been ordered to pass along
information about chronic diseases.
to the Times, the
rationale for mandatory reporting of blood-sugar-test (A1c)
results is to exercise "surveillance" of diabetes and employ
"more aggressive intervention."
City health officials are hoping to collect data on at
least 90 percent of those with diabetes-meaning the government
would obtain and analyze millions of test results. It is estimated that the New York City government
would keep information on approximately 500,000 citizens, including
mandatory reporting, health officials point out that these other
registries are already in operation:
· New York State, Department of Health (NYS DOH) Cancer
· NYS DOH Alzheimer's and other Dementias Registry
· NYS DOH Congenital Malformations Registry
· New York City, Department of Health and Mental Hygiene
(NYC DOHMH) Communicable Disease Registries
· NYC DOHMH Lead Registry
· NYC DOHMH Immunization Registry
· National VA [Veterans Administration] Diabetes Registry
Public Hearing on Blood-Sugar-Test Registry
hearing is expected to be held in August and the department
of health could pass a regulation as early as September. Whether
you live in New York City or not, you should consider how such
a trend could affect your health privacy and freedom.
you should become informed about the role and responsibilities
of your local boards of health.
After all, tax dollars support them, and health officials
are working for the citizenry.
According to the National Association of Local Boards
of Health, more than 70 percent of health boards report they
are responsible for recommending public-health policy; proposing,
adopting and enforcing public-health regulations; and recommending
health-department budgets and priorities. Boards are typically small, with 74 percent having
at most seven members.
In a free
society, government serves the citizens-it is not the master,
not even when it comes to public-health activities.
· New York
Times, "City Officials Aim to Track How
Diabetics Manage Illness," July 8, 2005
· New York City Department of Health and Mental Hygiene,
"NYC A1C Registry": http://www.nyc.gov/html/doh/downloads/pdf/
· New York City Department of Health and Mental Hygiene's
· National Association of Local Boards of Health (NALBOH),
"About Local Boards of Health."
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HHS Proposes Centralized "System of
Records" for Health-Care Investigations
Submit Public Comments
by AUGUST 7!
Department of Health and Human Services (HHS) announced in the
Federal Register of
July 6 its proposal to create a new system of records (SOR). The public should submit
comments on the proposal by August 7. (Saturday, August 6 would
be the last day to postmark mail; no option is cited for sending
comments electronically). HHS
says that "We may defer implementation of this SOR or one or
more of the routine use statements listed below if we receive comments that persuade us to defer implementation."
SOR will be titled the Health Insurance Portability and Accountability
Act (HIPAA) Information Tracking System (HITS). Its purpose is to:
apparent violations of the Transactions and Code Sets, Security,
and Unique Identifier provisions of HIPAA;
if there were violations;
the results of investigations;
violations to law enforcement; and
and retrieve records of the investigations.
HHS also proposes the following additional "routine"
regulatory, reimbursement, and policy functions performed within
the agency, HIPAA entities, or by a contractor or consultant;
another federal or state agency in the enforcement of HIPAA
regulations where sharing the information
is necessary to complete the processing of a complaint, contribute
to the accuracy of CMS's proper payment of Medicare benefits,
and/or enable such agency to administer a federal health-benefits
constituent requests made to a congressional representative;
litigation involving the agency; and
fraud and abuse in certain health-benefits programs.
The Federal Register announcement
notes that HITS would provide a single, central, electronic repository of complaint documents
and information, including investigative files, correspondence,
and administrative records.
more, the notice states, "HITS will maintain a file of complaint
allegations.. The collected information
will contain name, address, telephone number, health insurance
claim (HIC) number, geographic location, as well as, background
information relating to Medicare or Medicaid issues of the complainant."
that due to investigatory activities, it would exempt this new
system from the notification, access, correction and amendment
provisions of the Privacy Act of 1974. This means that citizens' personal health information
could be collected, stored and shared with many others involved
in investigations regarding Medicare and other issues. Yet, citizens (1) would not
be notified about the data collection; (2) would not have access
to the data; and (3) would not be able to correct and/or amend
misinformation or errors contained in the federal government's
COMMENTS BY AUGUST 7!
comments to the CMS Privacy Officer, Mail-stop N2-04-27, 7500
Security Boulevard, Baltimore, Maryland 21244-1850.
INFORMATION CONTACT: Michael Phillips, Health Insurance Specialist,
OESS, CMS, 7500 Security Boulevard, Mail Stop S2-24-15, Baltimore,
Maryland 21244-1849, Telephone Number (410) 786-6713, firstname.lastname@example.org.
(Volume 70, Number 128), July 6, 2005, pages 38944-48.
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Do Canadian Seniors Have More Health
Freedom than American Seniors?
to a recent article by Heritage Foundation researcher Derek
Hunter, "Canada's Medicare [program] now allows Canadians more
freedom (at least in Quebec) than American's Medicare does American
seniors." The article,
titled "Doing Your Own Health Care Thing: American Seniors vs.
Canadian Citizens," notes that because of Dr. Jacques Chaoulli's
recent Canadian Supreme Court victory overturning the
Quebec ban on private health insurance, Canadians in the province
are now free to contract with the physicians of their choice
and to purchase private health insurance for the services they
need and desire.
the article points out that the legal situation in the United
States remains unchanged.
Hunter writes, "Under the terms of Section 4507 of the
Balanced Budget Act of 1997, a senior can contract privately
with a physician for a 'covered' Medicare service if, and only
if, the doctor signs an affidavit to the effect that he is contracting
privately with the senior citizen, submits that affidavit to
the Secretary of the Department of Health and Human Services
(HHS) within ten days, and agrees to forgo all Medicare reimbursement
from all other Medicare patients for a period of two years."
"But this one-size-fits-all regulation does not fit the infinitely
varying circumstances of seniors and especially the Baby Boom
cohorts set to retire soon. In a free society, shouldn't a person's
own reasons for deciding to spend his or her own money on a
legal medical service without statutory or bureaucratic restrictions
be enough? Privacy, personal convenience, the need for specialized
care, or the skills and talents of a preferred physician could
all explain a senior wanting to purchase care outside of Medicare.
The current regulations make accommodating any of these reasonable
desires difficult and oftentimes impossible."
reports that to fix the current law Rep. Sam Johnson (R-Tex.)
in February introduced "The Medicare Beneficiary Freedom to
Contract Act of 2005" (H.R. 709). Hunter notes that the legislation "would
eliminate prohibitions on seniors' entering into private contracts
with medical professionals for legal medical services, regardless
of whether those services are covered by Medicare." However, on close examination H.R. 709 does
not make clear that seniors are free to contract privately for
all services under Medicare, including hospital (Part A) and
prescription-drug services (Part D). Thus to provide American seniors true freedom,
there needs to be a clear law stating that all citizens are
free to pay privately for the health-care services of their
choice, including services covered under all parts of Medicare.
proposed that allowing physicians to bill Medicare patients
an additional amount for Medicare-covered services would increase
seniors' freedom. (This is known as "balanced billing.") While balanced billing
can help patients who want to pay extra for Medicare-approved
services, it does not help restore the freedom to maintain private
contracts, which is the only way to bring decision-making power
back to patients and their physicians. He who pays the piper calls the tune. Without the precious
liberty to contract privately, citizens' health-care choices
will be dictated by Medicare and insurance decision-makers.
to move away from relying on and fostering a system in which
patients and physicians have to ask Medicare (and insurers):
"Big Brother, may I receive/give this treatment?" And in reforming Medicare, we must
stop building up Big Government health care (leaving health-care
decision-making power with bureaucrats and third parties) and
making wealthy people pay more for it!
"Doing Your Own Health Care Thing:
American Seniors vs. Canadian Citizens," by Derek Hunter (July
1, 2005): http://www.heritage.org/Research/HealthCare/wm782.cfm
· "Medicare Beneficiary Freedom to Contract Act of 2005"
(H.R. 709). To read the complete bill, visit the congressional
legislative database http://thomas.loc.gov
and search for bill number H.R. 709.
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Health Freedom Watch is published by the Insitute for Health Freedom. Editor: Sue Blevins; Assistant Editor: Deborah Grady. Copyright 2005 Institute for Health Freedom.